ArticleClinical infectious diseases : an official publication of the Infectious Diseases Society of America2017
What Is the More Effective Antibiotic Stewardship Intervention: Preprescription Authorization or Postprescription Review With Feedback?
Article in Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 83 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
83 citing papers in PubMed, 1 synthesis or guideline pooled it, 186 citations in OpenAlex.
- Recommendations for antibacterial prophylaxis in children receiving chemotherapy: a joint initiative of SITIP and infectious disease group of AIEOP.Italian journal of pediatrics · 2025Guideline
- Prospective Audit and Feedback by Antibiotic Stewardship Teams to Reduce Antibiotic Overuse at Hospital Discharge: A Stepped-Wedge Cluster-Randomized Clinical Trial.JAMA network open · 2026Trial
- Feasibility of Core Antimicrobial Stewardship Interventions in Community Hospitals.JAMA network open · 2019Trial
- Trial
- Impact of an integrated electronic Clinical Decision Support System with proactive Antimicrobial Stewardship Feedback on prescribing appropriateness: a 2-year single-centre time-series analysis.JAC-antimicrobial resistance · 2026Article
- Evaluating the effects of antimicrobial stewardship program on antimicrobial consumption and resistance patterns: a quasi-experimental study.BMC infectious diseases · 2026Article
- Analysis of Defined Daily Dose (DDD) and antibiotic problems in Intensive Care Unit (ICU) patients.Exploratory research in clinical and social pharmacy · 2026Article
- Evaluation of piperacillin-tazobactam appropriateness and underlying drivers of inappropriate prescribing in a Belgian University Hospital: a retrospective study.Antimicrobial resistance and infection control · 2026Article
- Temporal trends in antimicrobial consumption and an investigation of hospital antimicrobial stewardship activities through structured interviews.Antimicrobial stewardship & healthcare epidemiology : ASHE · 2026Article
- Supervised Machine Learning to Identify Hospital Inpatients Needing a Change of Antibiotic Therapy in Real Time: Preclinical Diagnostic Evaluation and Feasibility Study.Open forum infectious diseases · 2026Article
- Impact of a post-prescription audit and feedback antimicrobial stewardship intervention on inappropriate carbapenem prescribing: an interrupted time series analysis.JAC-antimicrobial resistance · 2025Article
- Impact of antibiotic post-prescription authorization in resource-limited emergency rooms and acute care units during the COVID-19 pandemic.BMC emergency medicine · 2025Observational
- Proactive antimicrobial stewardship with real-time microbiological alerts improves management of bloodstream infections.JAC-antimicrobial resistance · 2025Article
- Broad-spectrum and Watch antimicrobials are commonly used to treat hospital-acquired infections in German acute care hospitals: results from the 2022 national point prevalence survey.Antimicrobial resistance and infection control · 2025Article
- Computerized decision support for antimicrobial prescribing: what every antibiotic steward should know.Antimicrobial stewardship & healthcare epidemiology : ASHE · 2025Article
- Impact of hospital-related indicators on healthcare-associated infections and appropriateness of antimicrobial use according to a national dataset.Scientific reports · 2024Article
- Guidelines for Antibiotics Prescription in Critically Ill Patients.Indian journal of critical care medicine : peer-reviewed, official publication of Indian Society of Critical Care Medicine · 2024Article
- Prospective Audit and Feedback for Antimicrobial Treatment of Patients Receiving Renal Replacement Therapy in Community-Based University Hospitals: A before-and-after Study.Pharmaceuticals (Basel, Switzerland) · 2024Article
- Implementation and Perceived Effectiveness of Prospective Audit and Feedback and Preauthorization by US Pediatric Antimicrobial Stewardship Programs.Journal of the Pediatric Infectious Diseases Society · 2024Article
- Antibiotic Consumption 2017-2022 in 30 Private Hospitals in France: Impact of Antimicrobial Stewardship Tools and COVID-19 Pandemic.Antibiotics (Basel, Switzerland) · 2024Article
23 more citing papers are in PubMed but not listed here.
Corrections and comments
- Commented on by
- Erratum issuedErratum.2017
Authors and funding
9 authors at 7 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background: The optimal approach to conducting antibiotic stewardship interventions has not been defined. We compared days of antibiotic therapy (DOT) using preprescription authorization (PPA) vs postprescription review with feedback (PPRF) strategies. Methods: A quasi-experimental, crossover trial comparing PPA and PPRF for adult inpatients prescribed any antibiotic was conducted. For the first 4 months, 2 medicine teams were assigned to the PPA arm and the other 2 teams to the PPRF arm. The teams were then assigned to the alternate arm for an additional 4 months. Appropriateness of antibiotic use was adjudicated by at least 2 infectious diseases-trained clinicians and according to institutional guidelines. Results: There were 2686 and 2693 patients admitted to the PPA and PPRF groups, with 29% and 27% of patients prescribed antibiotics, respectively. Initially, antibiotic DOTs remained relatively unchanged in the PPA arm. When changed to the PPRF arm, antibiotic use decreased (-2.45 DOT per 1000 patient-days [PD]). In the initial PPRF arm, antibiotic use decreased (slope of -5.73 DOT per 1000 PD) but remained constant when changed to the PPA arm. Median patient DOTs in the PPA and PPRF arms were 8 and 6 DOT per 1000 PD, respectively (P = .03). Antibiotic therapy was guideline-noncompliant in 34% and 41% of patients on days 1 and 3 in the PPA group (P < .01) and in 57% and 36% of patients on days 1 and 3 in the PPRF group (P = .03). Conclusions: PPRF may have more of an impact on decreasing antibiotic DOTs compared with PPA. This information may be useful for institutions without sufficient resources to incorporate both stewardship approaches.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.